Ten-year alcohol consumption typologies and trajectories of C-reactive protein, interleukin-6 and interleukin-1 receptor antagonist over the following 12 years: a prospective cohort study.

S Bell,A Britton,G Mehta,K Moore

doi:10.1111/joim.12544

Abstract

BackgroundModerate alcohol consumption is thought to confer cardiometabolic protective effects. Inflammatory pathways are hypothesized to partly underlie this association.ObjectivesThe aim of this study was to examine the association between typologies of alcohol consumption and markers of inflammation, and their rate of change over time.MethodsData were collected from 8209 participants [69% men; mean age, 50 years (SD 6.1)] of the British Whitehall II study. Alcohol consumption typologies were defined using up to three measures during an approximately 10‐year period spanning from 1985 to 1994 as (i) stable nondrinkers, (ii) stable moderate drinkers (referent), (iii) stable heavy drinkers, (iv) nonstable drinkers and (v) former drinkers. C‐reactive protein (CRP), interleukin (IL)‐6 and IL‐1 receptor antagonist (IL‐1 RA) were measured up to three times in the following 12 years.ResultsStable moderate drinkers had lower levels of CRP than stable nondrinkers, stable heavy drinkers, former drinkers and nonstable drinkers, but there were no differences in the rate of change in CRP over time between groups. Stable nondrinkers had higher levels of IL‐6 as did stable heavy drinkers; rates of change in IL‐6 over time were also increased in the latter group. Stable nondrinkers also had higher levels of IL‐1 RA. These associations were robust to adjustment for confounding factors.ConclusionOur novel investigation of 10‐year drinking typologies shows that stable moderate alcohol consumption is associated with a long‐term inflammatory marker profile that is consistent with conferring a reduced risk of developing coronary heart disease.

Highlights

Moderate alcohol consumption is thought to confer cardiometabolic protective effects [1,2,3] and has been demonstrated to be related to a lower risk of a plethora of other disorders of different aetiology compared to both no alcohol and heavy alcohol intake [4]
Our novel investigation of 10-year drinking typologies shows that stable moderate alcohol consumption is associated with a long-term inflammatory marker profile that is consistent with conferring a reduced risk of developing coronary heart disease
Studies have demonstrated that higher levels of interleukin (IL)-6 are associated with an increased risk of coronary heart disease (CHD) [18], including studies examining long-term exposure to elevated IL-6 [19] or functional genetic variants of IL-6 signalling [20], suggesting that the association is causal

Summary

Introduction

Moderate alcohol consumption is thought to confer cardiometabolic protective effects [1,2,3] and has been demonstrated to be related to a lower risk of a plethora of other disorders of different aetiology compared to both no alcohol and heavy alcohol intake [4]. Numerous biological mechanisms have been put forward to explain the proposed cardiometabolic protection [5, 6], with favourable changes in high-density lipoprotein (HDL) cholesterol, fibrinogen and adiponectin supported by evidence from several small-scale randomized controlled feeding trials [7] These factors are unlikely to entirely explain the protective effects observed for moderate consumption and cardiometabolic outcomes compared to abstinence (or the increased risk observed amongst heavier drinkers), and their causal role in the aetiology of cardiovascular disease (CVD) remains unclear [8,9,10,11,12,13,14].

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